Does religion lead to more aggressive medical care?

Terminally ill cancer patients who lean heavily on religion to deal with their disease are about three times more likely than others in their shoes to receive aggressive treatment during their final days, according to a new study.

"Patients who rely more heavily on religion to cope are more likely to receive intensive life-prolonging care at the end of life," says Andrea Phelps, a senior internal medicine resident at Beth Israel Deaconess Medical Center in Boston, Mass. and co-author of the study published online yesterday in JAMA The Journal of the American Medical Association.

Phelps and her colleagues based their finding on interviews of more than 300 terminally ill patients being treated at cancer centers (in Connecticut, Texas, Massachusetts, and New Hampshire) about their use of religion as a coping mechanism. Among their queries: whether the patients were "seeking God's love and care" or were "looking for a stronger connection with God."

All of the patients died during the course of the study; after their deaths, the researchers reviewed their medical records and interviewed doctors, nurses, family members and other caregivers to find out if during their last week of life they were placed on ventilators (breathing machines) or received other intensive life-prolonging treatments such as cardiopulmonary resuscitation (CPR).

Their findings: 14 percent (or 24) of the 176 so-called religious copers received life-prolonging care compared with only 4 percent (or seven) of the 167 other patients.

"Religious copers may choose aggressive therapies because they believe that God could use the therapy to provide divine healing, or they hope for a miraculous cure while intensive medical care prolongs life," the scientists speculate in the study.

Study co-author Holly Prigerson, a psychiatrist at Harvard Medical School in Boston, Mass., says previous research suggests that in addition to hiking hospital bills, heroic life-saving measures may worsen a patient's end-of-life experience.

"You're putting patients through a pretty burdensome treatment." Phelps says. "The focus is not so much on comfort, but on prolonging life." She notes that heroic life-saving procedures often cause patients additional physical and emotional pain.

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